1. Why preparing for retiree health is important
Welcome and introductions
Emeriti Retirement Healthcare Savings Program

2. Forward thinking retirement planning includes healthcare
Emeriti Retirement Healthcare Savings Program
Forward thinking retirement planning includes healthcare
Emeriti and Aetna are here to help you make the most of your healthcare choices in retirement.

3. Medicare does not include long-term care coverage.
Know the facts
MEDICARE IS NOT ENOUGH
Medicare was never intended to cover all your healthcare expenses in retirement.
As you think about retirement – keep in mind that Medicare is not enough – only covering about 62% of your total healthcare expenses – NOT including long-term care.
Medicare does not include
long-term care coverage.

4. Healthcare in retirement adds up
Healthcare expenses not covered by Medicare
$273,000
Savings needed for a 65-year-old couple retiring today1
The blunt truth is that the average cost of healthcare for a couple, both aged 65 today, can constitute a significant portion of total retirement savings.
These figures represent healthcare costs not covered by Medicare. They do not include any Long-Term Care expenses.
EBRI Notes, 12/20/2017, Vol. 38, No. 10. National average. Savings needed for Medigap Plan F premiums, Medicare Part B premiums and out-of-pocket (median) drug expenses. Does not include long-term care. A couple with a goal of having a 90% chance of having enough savings to cover healthcare expenses in retirement needs $273,000.
For institutional investor use only. Not for use with or distribution to the public.

5. Healthcare could be your largest expense in retirement.
Expenses in retirement require different thinking — especially healthcare
Healthcare could be your largest expense in retirement.
During working years, wage-earners tend to allocate some portion of their paychecks to the many buckets—categories—they feel responsible for, including housing, food, utilities, debt service, and entertainment.
At retirement, the employer paychecks stop coming in and retirees need to live off of their savings. Rather than have one paycheck contributing a small amount to several buckets, many retirees choose to be more strategic by prioritizing buckets and then funding each one in its entirety before moving on to the next.
A key expense they will need to contribute more for is healthcare. Without employer-sponsored health benefits, they will have to shoulder a much larger portion of their healthcare costs—even with Medicare—at the life stage where their need for care will probably be the greatest.
It’s a good idea to give special care to how you allocate income, especially for healthcare which could take a larger chunk of it.
For institutional investor use only. Not for use with or distribution to the public.

6. Total Financial Security
Working together to create a financially healthy retirement
Income Security
Healthcare Security
Total Financial Security
As we close – we want to remind you that Emeriti and TIAA are working closely together to connect health and well-being for you and your dependents.

7. Income Security + Healthcare Security = Total Financial Security
Retirement Plan
Emeriti RHSP
Planning for general expenses
Planning for healthcare expenses
With Emeriti – you’re covered. You have your retirement plan for income replacement and your Emeriti Plan for healthcare replacement.
Taxable distribution of pre-tax contributions
Beneficiaries
Assets may be passed to estate after death
Tax-free reimbursement of qualified medical expenses
Covers eligible dependents
Balance forfeited at death if no eligible dependents
TIAA INTERNAL USE ONLY

8. Retirement Health Account Reimbursement Benefit Group Health Insurance
Emeriti’s three pillars of retiree healthcare
Tax-advantaged
Retirement Health Account
Use Assets Exclusively For Medical Expenses In Retirement
Tax-free
Reimbursement Benefit
For Qualified Out-of-Pocket Medical Expenses
Flexible
Group Health Insurance
Underwritten By Aetna
Emeriti provide three core components – health account, reimbursement benefit and group health insurance
Benefits available to retiree, spouse and eligible dependents

9. Triple tax-free healthcare savings
Employer contributions
Earnings
Reimbursement for qualified medical expenses
TIAA INTERNAL USE ONLY

10. Tax efficiencies help you preserve retirement income
$1,000 medical bill
Pay with Emeriti Health Account
Tax-free withdrawal $1,000
Pay with retirement plan account
Taxable withdrawal $1,500
33% federal income tax bracket
Let’s look at an example. $1,000 medical bill. You pay dollar-for-dollar with your Emeriti health account assets – but you have to pay taxes if you use your retirement plan assets.
This is a hypothetical example for illustrative purposes only. It assumes the retirement plan account does not include after-tax contributions. Actual tax consequences will vary based on a variety of factors, including your tax bracket and the type of contributions made to your retirement plan account. Please consult a tax advisor for assistance with your particular situation.

11. Tax-free reimbursements
RHSP Health Account
Health insurance premiums
COBRA
Vision, hearing & dental
Medicare & insurance co-pays
Qualified long-term care premiums
Medicare & insurance deductibles
Prescription drugs
Hospital & surgical expenses
Reimbursement for qualified IRC Section 213(d) medical expenses1
Benefits available to retiree, spouse and eligible dependents
If you meet vesting requirements when you terminate, you can start using, based on plan rules determined by employer
If a medical expense is not qualified as defined by IRS Section 213(d), the reimbursement request is denied.

12. Employer will start making annual contributions when you are age 35
Who makes contributions?
Employer will start making annual contributions when you are age 35
Employee can make after-tax contributions anytime (consult your financial advisor before making any investment decision)
Who makes contributions – your employer – and you may may after-tax voluntary contributions. Share specific information, based on each institution.
Utilize payroll deduction during active service
Use ACH transfer from your bank account – even after you terminate or retire
Your voluntary contributions will be made on an after-tax basis
All earnings will accumulate and be paid out tax-free to help pay for qualified medical expenses

13. When can you use the money for reimbursement of qualified medical expenses?
When you terminate employment with 5 years of service and reach age 55.
When can you access the funds – when you terminate with <<xx>> years of service – that is when you can start using the funds in your health account.

14. Default: TIAA Lifecycle Investment Funds
How you get reimbursed
Emeriti Health Account
Default: TIAA Lifecycle Investment Funds at
REQUIRED STEP:
Move money into TIAA Money Market Fund
Submit claim online or by mail
Have your reimbursement deposited directly into bank account or sent as a check
TIAA INTERNAL USE ONLY

15. Building blocks of Medicare
Part A – (Hospital) and Part B (Medical) Original Medicare
Coverage provided by Medicare
Doctors and providers must accept Medicare
No monthly premium for Part A
Part B has a monthly premium – ($134 in 2018)
Part C – Medicare Advantage, PPO Plan Replaces Original Medicare
This is a busy slide. But the take-aways are pretty simple. There are four parts to Medicare – ABCD. Part A is hospital coverage and Part B is doctor coverage – together they represent ORIGINAL MEDICARE. If you don’t have any other insurance in retirement – you would rely on Parts A and B for your coverage. (REVIEW BULLET POINTS) Part C is Medicare Advantage - it replaces ORIGINAL MEDICARE. Instead of using Parts A and B – you use a Medicare Advantage insurance plan. (BULLET POINTS). Part D is your prescription drug coverage. You’re responsible for obtaining a Medicare-approved Rx plan. (Bullet Points). The good news is - Emeriti provides three different Medicare Advantage Plans and three different Medicare-approved Part D Rx plans. So you have a starting point from which to begin setting up your retiree health coverage.
Private insurers, approved by Medicare, provide Parts A & B coverage
You will get extra benefits
Most doctors and providers accept Medicare and the Medicare Advantage plans
Monthly plan premium - varies by individual carriers
Part D – Prescription Drug
Private insurers, approved by Medicare, provide coverage
Different plans cover different drugs at different levels
Monthly plan premium – varies by individual carriers

16. Benefits available to retiree, spouse and eligible dependents
How Aetna Medicare Advantage Plans Work
Simple: Medicare Advantage is an all-in-one plan
Easy to use
One ID card for medical Rx
More benefits than Original Medicare Parts A and B
Care advocacy programs
Wellness benefits
One monthly Explanation of Benefits for each medical and pharmacy
Here’s how they work – Aetna is your primary insurance. You use one Aetna card. Your costs are simplified – no Medicare deductibles and no plan deductibles. And – you get extra benefits – this year, annual eye and hearing exams, SilverSneakers and Resources for Living.
Benefits available to retiree, spouse and eligible dependents
For institutional use only. Not for use with or distribution to the public.

17. How Aetna Medicare Advantage Plans Work
Flexible: Customized plans support your access to providers
Covering you in or out-of-network:
Customized group plan – not available outside of Emeriti
Access to providers nationwide
Providers do not have to be in Aetna network
Same benefits in or out of network
No referrals needed
Covers retirees nationally
Here’s how they work – Aetna is your primary insurance. You use one Aetna card. Your costs are simplified – no Medicare deductibles and no plan deductibles. And – you get extra benefits – this year, annual eye and hearing exams, SilverSneakers and Resources for Living.
Benefits available to retiree, spouse and eligible dependents
For institutional use only. Not for use with or distribution to the public.

18. Benefits available to retiree, spouse and eligible dependents
How Aetna Medicare Advantage Plans Work
Holistic: Supporting your health journey
Working with you and your providers to meet the range of health needs
Preventive
Wellness
At-risk
Advanced
Fall Prevention Program
Flu Shot Reminder
Women’s Annual Health Reminder
Colon Cancer Screening Reminder
Healthy Home Visits
Silver Sneakers Program
24/7 Information Line
Personal Health Record
Resources for Living®
Diabetes Program
Coronary Artery Disease Program
Cerebrovascular Disease Program
Congestive Heart Failure Program
Home Health Aid
Comorbid Condition Management Program
Readmission Avoidance Program
Compassionate Care Program
Here’s how they work – Aetna is your primary insurance. You use one Aetna card. Your costs are simplified – no Medicare deductibles and no plan deductibles. And – you get extra benefits – this year, annual eye and hearing exams, SilverSneakers and Resources for Living.
Benefits available to retiree, spouse and eligible dependents
For institutional use only. Not for use with or distribution to the public.

19. How Aetna prescription drug plans work
Medicare-approved: Part D prescription drug plans
Aetna is your Rx insurance provider
Your costs vary based on plan and coverage tier
You use a drug formulary designed for Emeriti
You use your Aetna card
Emeriti’s Rx plans work in a similar fashion – Aetna is your provider. You use your Aetna card at the pharmacy. Your total Rx costs will vary based on prescription utilization and what coverage tier you reach as you utilize prescriptions. Aetna does provide an Emeriti-specific formulary for our members.
Benefits available to retiree, spouse and eligible dependents
NOTE: A formulary is a list of Part D prescription drugs covered by the Aetna plan.

20. Benefits available to retiree, spouse and eligible dependents
How Aetna dental works 1
Aetna is your dental insurance provider
One-time opt-in opportunity
12-month waiting period for major services; waived with evidence of continuing coverage
Not available as a stand-alone plan 2 3 4
Dental coverage is pretty straight forward – Aetna is your provider and you use your Aetna dental card. There is a one-time opt-in – which means you can enroll when your first eligible or wait – but after you enroll, if you decide to dis-enroll – you will not be able to re-enroll. There is a 12 month waiting period on major services – unless you show evidence of prior continuing coverage – and you can only enroll in dental if you enroll in a medical and Rx plan.
Benefits available to retiree, spouse and eligible dependents
Note: in the states of CA, OR, WA, the stand-alone Dental plan may be elected if the participant is enrolled in a Kaiser Permanente MAPD Plan, and with evidence of existing coverage.
Note: Dental not available in MD.

21. 1 2 3 When are you eligible for Aetna coverage?
Meet employer’s eligibility requirement for the Emeriti RHSP
Be age 65 (or older) and fully terminated from employment 1 2
You’re eligible to enroll in Emeriti insurance when you turn 65 and are enrolled in Medicare Parts A and B 3
Be enrolled in Medicare Parts A & B

22. Enroll in the Aetna Rx Standard Plan as a stand-alone option
Optional approach
Enroll in a supplemental medical plan outside of the Aetna plans
Preserve your ability to enroll in Aetna medical and dental plans in the future
Enroll in the Aetna Rx Standard Plan as a stand-alone option

23. Benefits available to retiree, spouse and eligible dependents
Things to keep in mind
WHO CAN USE THE EMERITI BENEFIT?
You and your spouse and other eligible dependents can use the money in your health account to get reimbursed for qualified medical expenses
You and your spouse and other eligible dependents can enroll in the Aetna coverage
If you pass away, your spouse and eligible dependents may continue using the full benefit
WHAT IF I DON’T ELECT AETNA COVERAGE PROVIDED THROUGH EMERITI?
You will have a one-time opportunity to enroll unless you have a qualifying life event in the future
You can use the money in your health account to pay for any retiree health insurance and qualified out-of-pocket medical expenses
Benefits available to retiree, spouse and eligible dependents

24. The lead up to retirement
Call Emeriti Service Center to request enrollment kit
ONGOING
3 MONTHS BEFORE YOU RETIRE
1 MONTH BEFORE YOU RETIRE
As you countdown to retirement – watch for ongoing information from Aetna about Medicare and your Emeriti plan. 3 months before you retire, call the Emeriti service center to request an insurance enrollment kit. One month before you retire – enroll in the plans of your choice.
Receive information in the mail from Aetna & attend campus workshops
Enroll in insurance plans of your choice & plan ahead to track expenses for reimbursement

25. Not sure which Aetna plan is best for you?
CALL AETNA SPECIALISTS FOR HELP WITH CHOOSING PLANS
If you’re unsure about which plans to choose – call Aetna specialists who will provide personalized counseling for you and your dependents.

26. Thank You
QUESTIONS?
Thank you. Do you have additional questions?

27. ADDENDUM
Thank you. Do you have additional questions?

28. Qualifying life events - part 1
LIFE EVENT IS VALID
WHO CAN ENROLL?
LIFE EVENT DATE
COVERAGE BEGINS
Loss of Prior Coverage beyond control of the retiree (example: terminating employment, current medical plan is terminated; or moving out of state where that coverage is no longer available)
30 days
Retiree, spouse/ domestic partner and any pre-majority dependent children (up to the 26th birthday)
Date that prior coverage ended
All enrollees’ coverage begins the 1st of the month following the phone call to enroll
Gain spouse/domestic partner
Spouse/domestic partner, and pre-majority dependents
Date of marriage/ gaining domestic partner
Gain Dependent Child(ren) as a result of marriage
Retiree and their newly gained pre-majority dependent child(ren)
Date the child becomes a Dependent Child

29. Qualifying life events – part 2
LIFE EVENT IS VALID
WHO CAN ENROLL?
LIFE EVENT DATE
Dependent Spouse or Domestic Partner turns 65
90 days
Spouse or Dependent ONLY; *Retiree must already be enrolled in Emeriti insurance
Later of Spouse or Dependent Medicare Part A date, Part B Date, or 65th Birthday
Participant becomes Medicare eligible due to retirement or disability
Retiree, Disabled Participants or Dependents
Medicare Parts A and B enrollment date
Cessation of COBRA
30 days
Retiree, spouse/domestic partner and any dependent children up to majority
Company out of business resulting in loss of coverage for spouse/dependents

30. Qualifying life events – part 3
LIFE EVENT IS VALID
WHO CAN ENROLL?
LIFE EVENT DATE
Termination of Medical Plans
30 days
Retiree, spouse/domestic partner and any dependent children up to majority
Death of Active Employee who has met F&M retirement criteria while employed*
90 days
Any surviving spouse/domestic partner and dependent children – may enroll in pre-65 or post-65 coverage when appropriate
Participant’s date of death
*death of participant prior to obtaining institution retirement criteria results in no coverage for any surviving dependents.
*keep in mind if a participant terminates employment and has met your retirement criteria but continues to work and is covered by their “active coverage” outside of F&M, they will still be eligible to enroll in the Emeriti insurance once they terminate that employment. If a participant terminates employment but elects another retirement health plan (AARP, BCBS, etc.) they are waiving their eligibility to enroll in the Emeriti coverage. IF the AARP, BCBS, etc. plan is terminated or the retiree moves out of the area and the plan they are enrolled in is not offered that is a Qualifying Life Event and would allow the retiree to enroll in the Emeriti insurance at that point.
*scenarios may be reviewed on a case-by-case basis to determine eligibility due to loss of coverage per Aetna’s approval.

31. This material is for informational or educational purposes only and does not constitute investment advice under ERISA. This material does not take into account any specific objectives or circumstances of any particular investor, or suggest any specific course of action. Investment decisions should be made based on the investor’s own objectives and circumstances.
Interests in any retiree healthcare plan discussed herein are offered solely by the employer.
HealthPartners are independent corporations and are not legally affiliated. The full name of Emeriti Retirement Health is The Emeriti Consortium for Retirement Health Solutions, an Illinois Nonprofit Corporation. Emeriti Retirement Health is not an insurance company, insurance broker or insurance provider.
The Emeriti Program is delivered in collaboration with TIAA, CBIZ RPS, Aetna Life Insurance Company, and HealthPartners. 
Teachers Insurance and Annuity Association of America (TIAA) is Emeriti’s accumulation record keeper, trust services provider, and investment manager. TIAA is a leading provider of financial services to nonprofits offering investing, banking, advice and guidance, and retirement services. TIAA has helped institutions and individuals pursue financial well-being for 100 years.
CBIZ RPS provides services in connection with the Emeriti group insurance administration and Emeriti medical expense reimbursement processing. Headquartered in Cleveland, Ohio, CBIZ RPS has 26 offices around the country and more than forty years of experience in providing full-service benefits services supporting employees and retirees in organizations nationwide.
Aetna Life Insurance Company is the primary health insurer for the Emeriti Program, providing fully insured medical insurance and health-related products. For over 150 years, Aetna has been an innovator in the delivery of insurance solutions and is a nationwide provider of Medicare-approved Part D prescription drug services.
For Minnesota institutions and their Minnesota-resident retirees, HealthPartners provides participants with medical insurance and healthrelated products. HealthPartners is the largest consumer-governed nonprofit health care organization in the nation.
Teachers Insurance and Annuity Association of America (TIAA) will provide services to the plan and may issue plan communications on behalf of the plan sponsor, in its capacity as a plan record keeper.
TIAA group of companies cannot and does not provide tax or legal advice and recommends that plan sponsors consult their own legal and tax advisors for such advice.
FOR INSTITUTIONAL USE ONLY. NOT FOR USE WITH OR DISTRIBUTION TO THE GENERAL PUBLIC.